DIGITAL NERVE BLOCK THROUGH FLEXOR TENDON SHEATH AT THE PALMAR LEVEL

Abstract

Injury of finger is one of the most common injury of upper extremities. Most of these injuries are managed under the local anesthesia. Conventional digital nerve block is technically easy, but has drawbacks of multiple injections, increased risk of nerve injury and compromise of circulation. A new approach to achieve digital nerve block through the flexor tendon sheath as an avenue introducing anesthetics to the core of digit is described. Through centrifugal anesthetic diffusion all four digital nerves are anesthetized rapidly. This technique involves palmar percutaneous injection of less than 5ml of lidocaine into the potential space of the flexor tendon sheath at the level of distal palmar crease. Over the last 4 years, authors used this technique on 30 patients without anesthetic complication.